选择性动脉插管持续灌注化疗治疗晚期胰腺癌的疗效分析

背景与目的：晚期胰腺癌化学治疗效果差。本研究目的是探讨选择性动脉插管持续灌注化疗治疗晚期胰腺癌的临床疗效与应用价值。方法：20例晚期胰腺癌经选择性动脉插管持续灌注化疗。采用Seldinger技术经股动脉插管留置导管12例,经左锁骨下动脉插管植入药盒导管系统8例。导管选择至肿瘤供血动脉持续灌注化疗药物。9例采用THP-ADM HCPT 5-FU／CF方案,11例采用GEM CBP 5-FU／CF方案,4天为一疗程。4～6周重复1次疗程。治疗后观察客观缓解率、临床受益疗效(CBR)和病人的生存时间。结果：客观缓解率10％(CR、PR各1例),临床受益疗效70．0％,6个月及9个月生存率分别为58．8％和39．2％,中位生存期8．8个月。无出现插管合并症。结论：选择性动脉插管持续灌注化疗治疗晚期胰腺癌安全可靠。临床受益疗效良好,可提高患者的生存质量和生存期。值得临床进一步观察研究。

Efficacy of selective continuous transarterial infusion chemotherapy on advanced pancreatic cancer

BACKGROUND &OBJECTIVE: Advanced pancreatic cancer is mainly trea te d by chemotherapy with poor prognosis. This study was designed to evaluate clini cal efficacy and application of selective continuous transarterial infusion chem otherapy in treating patients with advanced pancreatic cancer. METHODS: Twenty p atients with advanced pancreatic cancer were treated by selective continuous tra nsarterial infusion chemotherapy. The interventional treatment was performed wit h Seldinger technique,12 patients received percutaneous femoral artery cannuliza tion and catheter retention,8 received percutaneous left subclavian artery port -catheter system implantation. Chemotheraputic drugs were continuously infused when the catheter was selectively placed in turner feeding artery. Nine patients were treated with pirarubicin (THP)/adriamycin (ADM) plus hydroxycamptothecin ( HCPT),and 5-fluorouracil (5-FU)/calcium folinate (CF) regimen,and 11 were trea ted with gemcitabine (GEM) plus carboplatin (CBP),and 5-FU/CF regimen. Treatmen t regimens were repeated every 4-6 weeks with each cycle of 4 days. Tumor respo nse rate,clinical benefit response (CBR),and survival time were observed. RESULT S: Objective response rate was 10%with 1 case of complete remission (CR),and 1 case of partial remission (PR), CBR was 70%(14/20), 6-,and 9-month survival r ates were 58.8%,and 39.2%. Median survival time for all patients was 8.8 month s. No complication related to cannulization was found. CONCLUSION: Selective con tinuous transarterial infusion chemotherapy is safe,and has good efficacy in tre ating patients with advanced pancreatic cancer,it may prolong survival time of p atients.